Best practices to engage your workforce in their healthcare benefits.
By Audrey Boone Tillman and Alan Spiro
Having employees take more control of their health and wellness benefits is on the agenda for many HR executives in 2014. So HRO Today asked two experts to offer their insight into engaging employees in consumer-driven healthcare. Audrey Tillman, Aflac’s executive vice president of corporate services, and Alan Spiro, chief medical officer for Accolade, address the state of health benefits and offer some best practices to get your workforce behind the driver’s wheel of their health and healthcare management.
Empower Your Employees
By Audrey Boone Tillman
The American workforce is gaining more control over its healthcare insurance. Consumer-driven health plans (CDHP) place costs and care in the hands of employees, which has already proven to drive down overall healthcare costs according to some reports.
Unfortunately, not all workers feel empowered by this shift. The confusion around CDHPs can be costly—for both workers and their employers. What is consumer-driven healthcare?
As its name implies, a consumer-driven healthcare model gives employees the primary decision-making role regarding the healthcare they receive. There are several health insurance plans that are commonly part of a consumer-driven model, including health savings accounts (HSAs) and health reimbursement accounts (HRAs).
These are generally offered alongside a high-deductible health plan (HDHP) to help protect policyholders from catastrophic medical expenses.
As the remaining healthcare legislation is implemented through 2018, including the tax on expensive health plans, more employers are likely to adopt consumer-driven health plans or shift completely to this model.
However, the 2013 Aflac WorkForces Report reveals a wide gap in employee readiness to take on the shift toward consumer-driven healthcare and defined contribution models. Where are the issues and concerns?
- 72 percent have never even heard the phrase consumer-driven healthcare
- 54 percent would prefer not to have more control over their insurance options
- 30 percent of workers say that when selecting an insurance plan they have a full understanding of the deductible cost
- 15 percent did not even check that their coverage deductibles were correct or that their preferred medical professional was in their network.
Most concerning of all: While 75 percent of the workforce thinks their employer will educate them about changes to their healthcare coverage as a result of reform, only 13 percent of employers say educating their employees about healthcare reform is important to their organization.
This needs to change. Organizations should take steps to educate employees about the scope of options. Here are some best practices for engaging your workforce in CDHPs:
1. Offer a robust menu of options. To succeed in turning what most employees see as an unfavorable form of “cost-shifting” on its head, present a robust menu of benefits options. In a defined contribution model plan, for instance, the fixed contribution amount helps employers keep costs predictable, and the flexibility allows employees the opportunity to select a plan based on their needs. The greater the coverage, the most expensive the contribution from the employee. These fixed contributions can and should be allocated to different pockets, such as major medical, dental, voluntary insurance, and HSAs. Voluntary insurance plans can provide a much-needed financial safety net in the face of a high-deductible health plan.
2. Customize the conversation. In preparing for a move to a consumer-driven model, assess the demographics and health status of the covered workforce. Begin by determining health opportunities and risks by participating in biometric screenings and health-risk assessments. Having this data can help dictate the best model for your organization, and allow you to tailor your communication program to fit the needs of your company structure and industry. Some companies offer their workers customizable worksheets to plug in their own individual information and calculate their potential medical costs for the year.
3. Increase and diversify communication. Frequent communication is paramount for instituting healthcare changes—sending a yearly message during open enrollment is no longer adequate. Diversify materials to include print, email, Intranet, and face-to-face meetings. Be sure to utilize social and mobile media such as texts, Twitter, and Facebook to remind workers of upcoming open enrollment deadlines.
4. Simplify the language of benefit communications. Include clear explanations of healthcare jargon. Often employees are embarrassed to admit they don’t understand concepts such as deductibles or copayments. Use the same terminology and clear explanations in every communication vehicle, keeping benefit materials consistent.
5. Engage brokers. Insurance agents can help keep the lines of communication open by helping employers where and when employees want guidance.
Equip Your Employees
By Alan Spiro
Many organizations consider improving participation in health programs and educating employees to be better healthcare consumers as one of their top priorities over the next three years. Yet, despite their best efforts, actual participation in those programs is low. Nearly eight in 10 employers see “lack of engagement” as the biggest obstacle to building a healthier workforce, according to a report from the National Business Group on Health and Towers Watson.
Employees, on the other hand, are being asked to shoulder a greater share of responsibility for their overall health and healthcare. But asking employees to navigate an often-complex healthcare delivery system without giving them the tools they need to make informed decisions will only lead to frustration. Redefine healthcare engagement as better equipping your employees to take charge of their health and improve their wellbeing.
1. Think beyond the communications strategy. Real engagement can be built on a foundation of trust. Real engagement occurs when you give your employees the support and tools at the point they need to engage with their healthcare on their terms, at a time and place that’s right for them. Leverage the everyday interactions employees have with their health and healthcare. For instance, ask for feedback about their experience when they call the number on the back of their insurance card. Or, if you have a company cafeteria, make the healthy choices the easiest choices.
2. Address the “whole person.” Your employees’ day-to-day ability to stay or get healthy is impacted by everything that’s going on in their lives. You think about the bottom line, but they think: “Can I afford my medication? Who’s going to take care of my children when I go to the doctor? How will I get to the grocery store?” Programs that focus only on conditions, and not on the context of your employees’ lives, will fall short. What resources can you provide that will help employees navigate the logistical hurdles to care that are a normal part of the lives of your employees and their loved ones? For instance, helping an employee find respite care for an aging parent may allow her to get that checkup she’s been putting off.
3. Help them make better decisions. You and your employees want the same thing: For them to get the right care at the right time. It leads to better outcomes, lower costs, and higher quality of life. But many programs focus only on reducing errors in healthcare delivery. While that’s important, far more errors occur in the day-to-day decisions your employees make—the decisions that affect their health. They skip preventive screenings. They go to the emergency room not because it’s appropriate, but because they’re scared. They agree to a diagnostic test they may not need. They don’t get the right treatment or they don’t follow through with their treatment. Give your employees resources that help them understand what questions to ask about their care—and that teaches them how to ask those questions. Don’t focus only on episodic health education, which in traditional care management programs is often triggered after they’ve received care.
4. Build relationships, not transactions. Your employees need to trust that those who help them with their healthcare have no other agenda than their wellbeing—a reason the field of “personal health assistance” has been growing exponentially. A personal health assistant stays with clients every step of the way, handling the often-complicated logistics related to benefits. Building this type of trust can lower medical costs and make employees two times less likely to delay getting the care they need.
5. Simplify, simplify, simplify. Healthcare and healthcare benefits have never been more complex. By offering services that reduce that complexity and the legwork your employees have to do, you’ll increase their capacity to make informed healthcare decisions. One simple way to achieve this is to reduce the number of separate phone calls your employees have to make to access programs. Rather than having multiple programs that support member services, disease management, case management, and more, provide employees with a single resource that can address questions and coordinate care across a wide spectrum of needs. Give them the ability to navigate the complicated healthcare system by cutting the jargon and explaining benefit and treatment options clearly and simply.
Audrey Tillman is Aflac’s executive vice president of corporate services. Alan Spiro, MD, MBA, is chief medical officer for Accolade.